• Review criteria to determine if the request can be approved• Accurately enter Prior Authorization in claims system to ensure appropriate claims will adjudicate• Respond to completed requests by creating written communication of the clinical outcome to the member and the member’s physician within client specific turnaround times• Research and respond to calls and emails• Perform outreach to pharmacies and physician’s offices related to the department process across multiple clients to obtain all necessary information related to UM requests, including occasional member assistance• Provide all relevant clinical information specific to a UM request to a department Pharmacist and the Physician• Manage work queue and volumes to meet client specific turnaround times• Other duties as assigned• Commercial: Responsible to be proficient in one area (i.e., intake, research, etc.); area assignment is based on department need• Government Programs: Responsible to be proficient in single review, approval/denial, etc.

• Complete concurrent quality control• Serve as technical resource for questions related to daily quality monitoring process and workflow• Provide feedback and remediation based on findings• Assist with research and completion of various ad hoc projects as they relate to Quality Audit requests• Complete concurrent quality control• Serve as technical resource for questions related to daily quality monitoring process and workflow• Provide feedback and remediation based on findings• Assist with research and completion of various ad hoc projects as they relate to Quality Audit requests• Other duties as assigned

Provides account services to customers by receiving deposits and loan payments; cashing checks; issuing savings withdrawals; recording night and mail deposits; selling cashier's checks, traveler's checks, and series e bonds; answering questions in person or on telephone; referring to other bank services.Records transactions by logging cashier's checks, traveler's checks, and other special services; preparing currency transaction reports.Cross-sells bank products by answering inquiries; informing customers of new services and product promotions; ascertaining customers' needs; directing customers to a branch representative.Completes special requests by closing accounts; taking orders for checks; opening and closing christmas and vacation clubs; exchanging foreign currencies; providing special statements, copies, and referrals; completing safe-deposit box procedures.Reconciles cash drawer by proving cash transactions; counting and packaging currency and coins; reconciling loan coupons and other transactions; turning in excess cash and mutilated currency to head teller; maintaining supply of cash and currency.Complies with bank operations and security procedures by participating in all dual-control functions; maintaining customer traffic surveys; auditing other tellers' currency; assisting in certification of proof.Maintains customer confidence and protects bank operations by keeping information confidential.Contributes to team effort by accomplishing related results as neede